Victoria M. Rizzo

Social work support services for stroke patients : interventions and outcomes

Abstract This study aims to better understand the influence of social work support services on the efficient use of rehabilitation services (LOS-EFF) and total hospital charges for individuals participating in an inpatient physical rehabilitation program following stroke. Although the effects of the social work support services on stroke outcomes were modest, the study found that these services influenced stroke outcomes. Most importantly, the study revealed that higher levels of informational social work support services were associated with lower total hospital charges.

Cost Outcomes and Social Work Practice

In response to escalating health care costs, especially costs for which Medicare and Medicaid are the primary payers, government officials, policy makers, and health administrators have placed increasing pressure on health care providers and mental health providers to answer the following question: What is the relationship between the cost of the services provided and the benefit to the consumers receiving it? In other words, can health and mental health providers demonstrate the cost-effectiveness of the services they provide to consumers? Answers to these questions are increasingly used to determine reimbursement structures for private insurance, Medicaid, and Medicare. Therefore, evidence about the costeffectiveness of social work interventions is needed to convince government officials, policy makers, and health administrators that these services are essential. For this reason, the use of economic analysis to examine the efficacy of social work practice is the focus of this special issue. What is cost-effectiveness analysis? Several methods for the economic evaluation of health and mental health interventions exist, including cost-identification analysis, cost-utility analysis, cost-benefit analysis, cost-consequences analysis, and cost-effectiveness analysis (Drummond, O’Brien, Stoddart, & Torrance; Neumann, 2005). However, the evaluation method receiving the most attention of late is cost-effectiveness analysis (CEA). Its prominence is a result of the recommendations of The United States Panel on Cost-Effectiveness in Health and Medicine (Weinstein, Siegel, Gold, Kamlet, & Russell, 1996) and the fact sheet entitled, “Focus on Cost Effectiveness Analysis at the Agency for Healthcare Research and Quality” (AHRQ; U.S. Department of Health and Human Services Public Health Services (USDHHS/PHS), 2001). CEA is the recommended economic evaluation method because

Psychosocial problems among patients in neighborhood health centers: perspectives from health care providers.

Little is known about how health care professionals perceive and understand the psychosocial problems of individuals receiving services in neighborhood health centers (NHCs). We conducted interviews with health care professionals in NHCs in New York City. The respondents identified seven problems, including a lack of financial resources, unsafe housing, and emotional distress/depression as affecting large portions of their patient populations. Respondents reported that they are presently meeting many of the psychosocial needs of their clients, but they were pessimistic about their ability to continue to do so due to a lack of funding streams to support their provision of comprehensive health care that includes psychosocial services. The findings suggest that while NHCs may be “holding their own” in providing quality services to their clients, this will be harder to sustain in the future if the numbers of the uninsured served continues to increase, and the revenues generated continue to decrease.

The impact of technology on the "older" nurse.

There is a crisis in the healthcare workforce. Today there are 35 million Americans ages 65 or older, but in less than 10 years, 76 million baby boomers will begin turning 65. Thus, by 2011, at least one in every five persons in our country will be an “older adult” (U.S. Department of Commerce Census Bureau, 2000).

The impact of technology on the "older" nurse: findings of the study: part 2.

This article presents the results of a study identifying older nurses’ response to using various technology in their practice. This study measured nurses working with wireless peripheral devices, such as blood pressure cuffs, pulse oximeters, scales, glucometers, and digital thermometers, and monitoring units that were placed in the patient’s home. Findings have implications for both older and younger clinicians as these types of products and systems can affect productivity, visit time, and assessment accuracy.